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This study evaluates the long\u2010term outcomes of 3D\u2010printed custom hemipelvic reconstruction with a focus on the integration of auxetic biomaterials with a negative Poisson's ratio to optimize mechanical properties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on 12 patients with primary pelvic malignancies who underwent reconstruction using 3D\u2010printed hemipelvic prostheses between January 2018 and May 2023. Follow\u2010up duration was 48\u2009months (range, 29\u201364\u2009months) Oncological, functional, surgical, pain control, and radiographic outcomes were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the latest follow\u2010up, 8 patients (66.7%) were disease\u2010free, 3 (25%) had disease progression, and 1 (8.3%) died from metastatic complications. Functional outcomes improved significantly, with the MSTS\u201093 score increasing from 15 (range, 12\u201317) to 26 (range, 21\u201329). Pain scores decreased from 5 (range, 4\u20137) to 1 (range, 0\u20132). The median surgical duration was 270\u2009min (range, 150\u2013560\u2009min), with intraoperative blood loss averaging 3200\u2009mL (range, 1900\u20136300\u2009mL). Complications included poor wound healing in 2 patients (16.7%), managed with VAC drainage. No mechanical failures, loosening, or fractures occurred. Accurate osteotomy, prosthesis implantation, and screw fixation were achieved. Successful osseointegration was observed in all cases, with no signs of bone absorption or osteolysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>3D\u2010printed custom hemipelvic prostheses with auxetic biomaterials offer an effective solution for pelvic reconstruction, providing promising oncological, functional, and radiographic outcomes. These findings support the use of 3D printing in complex pelvic defect reconstruction, optimizing both osteointegration and mechanical strength.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70040","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T16:39:14Z","timestamp":1746117554000},"page":"1691-1701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Application of <scp>3D<\/scp>\u2010Printed Custom Hemipelvic Prostheses With Negative Poisson's Ratio Porous Structures in Reconstruction After Resection of Pelvic Malignant Tumors"],"prefix":"10.1111","volume":"17","author":[{"given":"Xin","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Orthopedic Research Institute West China Hospital, Sichuan University  Chengdu China"},{"name":"Model Worker and Craftsman Talent Innovation Workshop of Sichuan Province Sichuan University  Chengdu 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